Most Relevant Information
Provider Data
| NPI Number: | 1003582974 |
| Provider Name: | NICHOLE MARIE GREEN ARNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP61208028 |
Most Important Dates
| Enumeration Date: | 08/19/2021 |
| Last Updated: | 08/25/2021 |
Provider Practice Location
8503 W CLEARWATER AVE STE B
KENNEWICK
WA
993363100
Practice Location Phone/Fax
| Phone: | 5093033428 |
| Fax: |
Provider Mailing Location
8503 W CLEARWATER AVE STE B
KENNEWICK
WA
993363100
Provider Mailing Phone/Fax
| Phone: | 5093033428 |
| Fax: |